Background Injuries and violence are among the top five causes of death and disabilities among adolescents. Such negative experiences affect the adolescent’s sociocognitive development, sense of security, self-worth, and relation with peers. This can later act as a catalyst for the perpetration of violence or unintended consequences such as self-harm and suicide. While parents/caretakers, teachers, and community leaders must be aware of adolescents’ issues and capabilities, it still presents a conundrum to balance the interacting physical and psychological changes and the experiences of adolescents within society, often at multiple stages of development.

Objective This study aims to explore caregivers’ perspectives on key contextual issues around adolescent violence and self-harm injuries.

Methods We conducted twelve focused discussion groups (FGDs) with male and female caregivers of adolescents at three sites in India and Vietnam (Jodhpur, Warangal, Hai Phong). All FGDs were conducted in person for 45 – 60 minutes and included 4 – 11 participants in each group. The recorded transcripts were translated into English and coded to provide a basis for thematic analysis to triangulate perspectives between groups.

Results The caregivers identified a range of issues affecting adolescents at individual, family, and societal levels. These include substance abuse, family and peer pressure, early marriages, domestic violence, community stigma, and expulsion from society among others. They also acknowledged the focus of the education system has changed from facilitating overall development to academic performance increasing pressure on students. Adolescents are also trapped between their education advancement and culture, especially for females. Respondents also mentioned the difficulties in detecting early warning signs of deteriorating mental health while some denied the existence of such issues. Many were unaware of the existing mental health services and how to utilize them.

Conclusion Identifying and remediating adolescent behavioral and mental health issues aren’t just a standalone intervention themselves, but a shared responsibility of the intersectoral linkage between the sociocultural contextual factors, parents, peers, schools, and communities at large. Targeted interventions require a holistic approach that considers key contextual factors such as those highlighted in this study and are implemented at various stages of the adolescent development period.